火针配合穴位埋线治疗囊肿型痤疮疗效观察及对皮肤屏障功能的影响

向亚玲 徐婷

[摘要]目的：觀察火针配合穴位埋线治疗囊肿型痤疮的疗效，并探讨对皮肤屏障功能的影响。方法：将笔者医院门诊收治的囊肿型痤疮患者分为联合组（n=94）和药物组（n=73），药物组予以异维A酸软胶囊治疗，联合组予以火针+穴位埋线治疗，治疗6周，比较两组临床疗效、皮损评分以及皮肤屏障功能相关指标情况，观察不良反应，统计随访2个月两组的复发情况。结果：联合组治疗后总好转率为92.55%，显著高于药物组的80.82%，差异有统计学意义（P<0.05）;治疗后，两组患者囊肿、结节、质地、肿痛、颜色各项皮损评分显著降低（P<0.05），联合组低于药物组（P<0.05）;两组患者粘脱蛋白质含量、TEWL、a值显著降低（P<0.05），角质层含水量显著升高（P<0.05），联合组优于药物组（P<0.05），两组pH值无显著差异（P>0.05）;两组患者均未见明显局部以及全身严重不良反应，随访2个月，联合组患者复发率为10.64%，明显低于药物组的26.03%，差异有统计学意义（P<0.05）。结论：火针配合穴位埋线治疗囊肿型痤疮疗效显著，可有效改善患者皮损症状，增强皮肤屏障功能，提高远期疗效。

[关键词]穴位埋线;火针;重度痤疮;囊肿型;皮肤屏障功能;皮损

Abstract： Objective  To observe the efficacy of fire needle combined with acupoint catgut embedding on severe cystic acne  and to explore its effects on skin barrier function. Methods Patients with cystic acne admitted to outpatient department of our hospital were divided into combined group （n=94） and drug group （n=73）. Drug group was treated with isotretinoin soft capsules， and combined group was given fire needle + acupoint catgut embedding， and they were treated for 6 weeks. The clinical efficacy， skin lesions scores and skin barrier function-related indicators were compared between the two groups， and the adverse reactions were observed， and the recurrence at 2 months of follow-up were counted in the two groups. Results The total improvement rate in combined group after treatment was significantly higher than that in drug group （92.55% vs 80.82%） （P<0.05）. After treatment， the scores of skin lesions of cysts， nodules， texture， swelling and pain and color were significantly decreased in the two groups （P<0.05）， and the scores in combined group were lower than those in drug group （P<0.05）. The mucoprotein and deprotein， TEWL and a value in the two groups were significantly decreased （P<0.05） while the water content of stratum corneum was significantly increased （P<0.05）， and the indexes in combined group were better than those in drug group （P<0.05）， and there was no significant difference in pH value between the two groups （P>0.05）. There were no obvious local and systemic serious adverse reactions in both groups. At 2 months of follow-up， the recurrence rate in combined group was significantly lower than that in drug group （10.64% vs 26.03%） （P<0.05）. Conclusion Fire needle combined with acupoint catgut embedding has significant efficacy in treating cystic acne， and it can effectively improve the symptoms of skin lesions， enhance skin barrier function and improve long-term efficacy.

Key words： acupoint catgut embedding; fire needle; severe acne; cyst type; skin barrier function; skin lesions

囊肿型痤疮属于痤疮中较为严重的类型，可发生于面部、颈部以及胸背等部位，皮损呈现多发性，其深部炎症可形成较大的囊肿或结节，破坏邻近正常组织，患者痊愈后容易形成凹陷性瘢痕，嚴重损害患者面部形象，给患者身心造成巨大的伤害[1-3]。系统性使用抗生素和维A酸类药物仍是治疗囊肿型痤疮的主要方法，但单纯使用药物治疗效果差，患者治疗后一段时间易反复发作[4]。近年来，火针、穴位埋线、耳针等方法治疗痤疮取得了不错的疗效[5-6]。本研究通过观察火针配合穴位埋线治疗囊肿型痤疮的疗效，分析其对皮肤屏障功能的影响，旨在为临床治疗囊肿型重度痤疮提供一定的理论根据。

1  资料和方法

1.1 一般资料：选择2014年5月-2018年12月于笔者医院美容科门诊就诊的200例囊肿型痤疮患者，获得167例基线资料无统计学意义的患者资料，按治疗方式不同将患者分为药物组（n=73）和联合组（n=94）。……